Laproscopic vacuum delivery apparatus for a diaphragm daper

Abstract

A laparoscopic vacuum delivery device is used for placing an epimysial electrode at the phrenic nerve motor point. The vacuum delivery device is adapted to hold the epimysial electrode while the electrode is introduced through a port into the abdomen during a laparoscopic procedure. The electrode is forcibly held against the diaphragm muscle surface for test stimulation using a suction ported through the delivery device. Multiple test sites may be explored by controlling the suction to and the position of the delivery device. The electrode is secured at an optimal location on the diaphragm muscle using an endoscopic stapler.

Having thus described the preferred embodiment, the invention is now claimed to be: 
     
       1. A vacuum delivery apparatus for laparoscopic implant of an operatively associated diaphragm pacer, the apparatus comprising: a first housing adapted on a first side for releasable attachment to said operatively associated diaphragm pacer;   a second housing connected to said first housing and including:   first vacuum source connection means for connecting the second housing to a first operatively associated vacuum source; and,   first port means defining a first opening on a first side of the second housing in fluid communication with said first vacuum source connection means; and,   a third housing connected to said first housing and including:   second vacuum source connection means for connecting the third housing to a second operatively associated vacuum source; and,   second port means defining a second opening on a first side of the third housing in fluid communication with said second vacuum source connection means.   
     
     
       2. The apparatus according to claim 1, wherein: said first port means is adapted to communicate vacuum from said first operatively associated vacuum source to the first side of the second housing through the first vacuum source connection means; and, said second port means is adapted to communicate vacuum from said second operatively associated vacuum source to the first side of the third housing through the second vacuum source connection means.   
     
     
       3. The apparatus according to claim 2, wherein the first side of the first housing, the first side of the second housing and the first side of the third housing are substantially disposed in a single plane. 
     
     
       4. The apparatus according to claim 3 further comprising: a first elongate vacuum tube, connected between said first vacuum source connection means and said first operatively associated vacuum source, for communicating vacuum from said first operatively associated vacuum source to said second housing; and,   a second elongate vacuum tube, connected between said second vacuum source connection means and said second operatively associated vacuum source, for communicating vacuum from said second operatively associated vacuum source to said third housing.   
     
     
       5. The apparatus according to claim 4 further comprising: first connecting means for loosely connecting said second housing to said first housing; and,   second connecting means for loosely connecting said third housing to said first housing.   
     
     
       6. The apparatus according to claim 5, wherein said first and second connecting means comprise said first elongate vacuum tube. 
     
     
       7. The apparatus according to claim 6, wherein said first housing and said third housing are both adapted to loosely receive said first vacuum tube. 
     
     
       8. The apparatus according to claim 7 further comprising: a manual positioning member;   an interface defined by said first housing, the interface being adapted to releasably receive a first end of said manual positioning member; and,   tether means attached to said interface defined by said first housing.   
     
     
       9. The apparatus according to claim 8, wherein said manual positioning member is adapted on said first end to axially receive said tether means. 
     
     
       10. The apparatus according to claim 9, wherein said interface includes a first keyed portion and said manual positioning member includes a second keyed portion adapted for selective mated coupling with said first keyed portion. 
     
     
       11. The apparatus according to claim 9, wherein said manual positioning member is adapted to axially receive said tether means for the length of the manual positioning member. 
     
     
       12. The apparatus according to claim 1 further comprising: a manual positioning member;   an interface defined by said first housing, the interface being adapted to releasably receive a first end of said manual positioning member; and,   tether means attached to said interface defined by said first housing.   
     
     
       13. The apparatus according to claim 12, wherein said manual positioning member is adapted on said first end to axially receive said tether means. 
     
     
       14. The apparatus according to claim 13, wherein said interface includes a first keyed portion and said manual positioning member includes a second keyed portion adapted for selective mated coupling with said first keyed portion. 
     
     
       15. The apparatus according to claim 14, wherein said manual positioning member is adapted to axially receive said tether means for the length of the manual positioning member. 
     
     
       16. A laparoscopic pacer placement apparatus comprising: a diaphragm pacer;   a collective arrangement of relatively moveable connected portions, the arrangement including pacer connecting means in the form of a pocket on a first side of the collective arrangement selectively releasably attaching to said diaphragm pacer;   vacuum source connection means adapted to connect said collective arrangement to an operatively associated external vacuum source; and,   means defining an opening on said first side of the collective arrangement, the opening defining means in fluid communication with said vacuum source connection means and adapted to communicate vacuum from said associated vacuum source to diaphragm tissue adjacent said arrangement through said opening.   
     
     
       17. The apparatus according to claim 16, wherein said collective arrangement comprises first, second and third portions. 
     
     
       18. The apparatus according to claim 17, wherein said first, second and third portions are first, second and third rigid members respectively, loosely connected for an overall flexibility of said collective arrangement. 
     
     
       19. The apparatus according to claim 16, wherein said collective arrangement is adapted to move in substantial correspondence with movement of said diaphragm tissue. 
     
     
       20. The apparatus according to claim 16, wherein said collective arrangement includes independently moveable portions. 
     
     
       21. A vacuum delivery device for laparoscopic implant of an associated diaphragm pacer, the device comprising: a first member connected to a first operatively associated external vacuum source;   a first vacuum port on the first member connected to the first vacuum source;   a second member connected to the first member and adapted for releasable attachment to the associated diaphragm pacer;   a third member connected to the second member and connected to a second operatively associated external vacuum source; and,   a second vacuum port on the third member connected to the second vacuum source.   
     
     
       22. The device according to claim 21, wherein: the first port is adapted for communicating vacuum from the first vacuum source; and,   the second port is adapted for communicating vacuum from the second vacuum source.   
     
     
       23. The device according to claim 22, wherein the first and second vacuum ports are disposed in a single plane. 
     
     
       24. The device according to claim 22 further comprising: first vacuum communicating means for communicating vacuum from the first vacuum source to the first member; and,   second vacuum communicating means for communicating vacuum from the second vacuum source to the third member.   
     
     
       25. The device according to claim 24 further comprising means for connecting the first member to the second member and means for connecting the second member to the third member. 
     
     
       26. The device according to claim 25, wherein the means for connecting the first member to the second member and the means for connecting the second member to the third member comprise the second vacuum communicating means. 
     
     
       27. The device according to claim 26 further comprising: a manual positioning member;   an interface slot defined by the second member, the interface slot being adapted to releasably receive a first end of said manual positioning member; and,   a tether attached to the interface slot.   
     
     
       28. The device according to claim 27, wherein said manual positioning member is adapted on said first end to axially receive said tether. 
     
     
       29. The device according to claim 28, wherein said interface slot includes a first keyed portion and said manual positioning member includes a second keyed portion adapted for selective mated coupling with said first keyed portion. 
     
     
       30. The device according to claim 28, wherein said manual positioning member is adapted to axially receive said tether means for the length of the manual positioning member. 
     
     
       31. The device according to claim 21 further comprising: a manual positioning member;   an interface defined by the second housing, the interface being adapted to releasably receive a first end of said manual positioning member; and,   tether means attached to said second housing at said interface.   
     
     
       32. A method for laparoscopically placing an electrode at an optimal site on a body tissue comprising: a) receiving an electrode on a first side of a vacuum delivery apparatus;   (b) placing the vacuum delivery apparatus through a laparoscopic port and into a body;   c) positioning the first side of the vacuum delivery apparatus on a body tissue at a first site;   d) vacuum attaching the vacuum delivery apparatus to the body tissue by connecting the vacuum delivery apparatus to an operatively associated external source of vacuum; and,   e) during said vacuum attaching, applying an electrical signal to said electrode to stimulate the body tissue.   
     
     
       33. The method according to claim 32 further comprising the steps of: f) releasing the vacuum delivery apparatus from the body tissue by disconnecting the apparatus from said operatively associated external source of vacuum;   g) repositioning the first side of the vacuum delivery apparatus on said body tissue at a second site; and,   h) repeating steps d and e.